Since the publication of the “Guidelines for the Practice of Hospice Care (for Trial Implementation)” and the “Basic Standards and Management specification for the Hospice Care Center (for Trial Implementation)”, many medical institutions and nursing homes in China have established hospice care units or wards. The cause of hospice care has entered a new development stage. Due to insufficient theoretical and practical experience, there are many problems such as unclear concepts and uncertain concerns in the service, including equating hospice care with palliative care, paying attention to care rather than treatment, focusing on mental rather than physiology, and other misunderstandings. Moreover, there are many ethical dilemmas in the process of service such as the conflicts between traditional medical models and hospice care concepts, confidentiality and informed understanding, family decision-making and patient autonomy. This paper explains some misunderstandings and ethical dilemmas in the practice of hospice care, and proposes corresponding countermeasures.